In a new study from Lariboisiere Hospital in France, researchers found a link between larger waistlines and the progression of non-alcoholic fatty liver disease (NAFLD) in people with type 2 diabetes.
They found each 1cm increase in waist circumference was associated with a 5% higher likelihood of developing advanced fibrosis, a late stage of NAFLD.
NAFLD, in which fat builds up in the liver can progress to serious liver damage, including advanced fibrosis—potentially life-threatening scarring of the liver.
It is already known that up to 15-20% of those with type 2 diabetes have advanced fibrosis. But little is known about what effect, if any, it has on the complications of diabetes.
In the study, the team examined the link in 684 type 2 diabetes patients. The participants had an average age of 61, a BMI of 28.7 and a waist circumference of 104cm. 59% were male.
The team showed that 74.5% had NAFLD. In 12.4% of the participants, it had progressed to advanced fibrosis.
In addition, 24.8% of the participants had macrovascular complications of type 2 diabetes, such as heart disease.
20.5% had retinopathy (damage to the blood vessels of the retina); 39.4% had neuropathy (nerve damage), and 38.3% had nephropathy (kidney disease).
The team found nephropathy to be significantly more common in those with advanced fibrosis than the other type 2 diabetes patients.
52.1% of those with advanced fibrosis had nephropathy, compared to 36.3% of the other type 2 diabetes patients.
Rates of the other complications (macrovascular, retinopathy and neuropathy) did not differ between those with advanced fibrosis and the other type 2 diabetes patients. Again, more research is needed to confirm this.
The study also found that every 1cm increase in waistline was associated with a 5% increase in the likelihood of the participants developing advanced fibrosis.
Higher levels of AST, a marker of liver damage, were also linked to higher odds of advanced fibrosis.
The team suggests doctors treating people with type 2 diabetes should be aware of these links and check for advanced fibrosis when their waist circumference or level of AST is high.
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The study is published in Diabetologia. One author of the study is Dr. Tiphaine Vidal-Trécan.
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